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Organization
MIDWEST LAKES MEDICAL CENTER, SC
Active
Organization
MIDWEST LAKES MEDICAL CENTER, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKESH ARORA MD (DOCTOR)
(815) 455-8600
Entity
Organization
Contact information
Practice address
690 E TERRA COTTA AVE, SUITE D, CRYSTAL LAKE, IL 60014-3605
(815) 455-8600
(815) 455-8601
Mailing address
690 E TERRA COTTA AVE, SUITE D, CRYSTAL LAKE, IL 60014-3605
(815) 455-8600
(815) 455-8601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36097343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036 097 343
—
IL
01
—
05623054
BCBS ID
IL
Enumeration date
04/18/2008
Last updated
08/19/2014
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